Laparoscopic Stapler Duodenoduodenostomy for Congenital Duodenal Obstruction: A Six-Year Single-Center Experience

Background Laparoscopic stapler duodenoduodenostomy is an established minimally invasive technique for the treatment of congenital duodenal obstruction, including duodenal atresia and stenosis. Compared with open surgery, this approach has been shown to be safe and to provide advantages such as reduced surgical trauma, faster time to full enteral feeding and shorter hospital stay. Aims This study reports a single-center experience with laparoscopic stapler duodenoduodenostomy over a six-year period, focusing on perioperative management and short-term outcomes. Methods A retrospective analysis was performed of all patients who underwent laparoscopic duodenoduodenostomy for duodenal atresia or stenosis at our institution between November 2019 and December 2025. Results Sixteen patients underwent laparoscopic duodenoduodenostomy. A side-to-side duodenal anastomosis using the JustRight™ Hologic 5-mm stapler was performed in all cases. One patient with intestinal malrotation and an associated Meckel’s diverticulum required diagnostic laparoscopy followed by open diverticulum resection and small bowel anastomosis before completion of the duodenal stapled anastomosis. Most procedures were performed within the first days of life while one patient with duodenal stenosis underwent surgery at 18 months of age. Gestational age ranged from 35 + 1 to 40 + 4 weeks, and nine patients were male. Associated anomalies were present in seven cases. Mean body weight was 2.6 kg, ranging from 1.6 to 9.0 kg. Full enteral feeding was achieved after a mean of 11 days (range 4–16 days). Intraoperative complications included one stapler-related duodenal perforation and one stapler exchange, without postoperative consequences. Postoperative contrast studies revealed that anatomical correct duodenoduodenostomy could be achieved and ruled out anastomotic leakage or stenosis. Follow-up between 1 and 24 months showed no late complications. Conclusion Laparoscopic stapler duodenoduodenostomy can be safely performed in neonates and infants, with excellent short-term outcomes and intestinal recovery. The minimally invasive approach represents an effective alternative to open surgery.